Mixing vial

ABSTRACT

A vial (2, 202) has first and second chambers (56, 232; 54, 234) initially separated by a rupturable barrier (20, 212). The first chamber is a variable volume chamber defined by a cylinder (18, 208), the rupturable barrier at the second end (19, 214) of the cylinder and a piston (14, 228). The second chamber is created by a telescoping container (22, 226) mounted to a second end of the cylidner. The chambers are telescopically collapsed causing fluid pressure in the second chamber to rupture the barrier so the components mix in the first chamber. The piston is driven through the cylinder from pre-mix to post-mix positions by the liquid from the second chamber. This dislodges a safety shield (30, 226) at the first end of the cylidner to expose the piston. The mixed contents of the first, variable volume chamber are removed by inserting a needle cannula through the now exposed piston; aspiration of the mixed contents take place without the introduction of air into the first chamber since the piston moves back down the cylinder as the contents are removed. Structure (236; 242; 248, 250) can be used to prevent the inadvertent activation of the vial (202).

This is a Continuation-In-Part of U.S. patent application Ser. No.07/615,610, filed Nov. 19, 1990 for MULTI-CHAMBER VIAL, (now U.S. Pat.No. 5,114,411) the disclosure of which is incorporated by reference.

BACKGROUND OF THE INVENTION

Safe and effective drug therapy by injection depends not only uponaccurate diagnosis, but also on efficient and reliable introduction ofthe medical substance into the subcutaneous cellular tissue withoutintroducing contaminants or ambient air. The applicable drug orpharmaceutical must first be drawn from the resident container or vialinto a syringe before injection. The integrity and features of the vial,therefore, are influential over the overall safety of the injection.

Typically, great care must be taken when a needle cannula of a syringeis used in conjunction with a vial containing a pharmaceutical to beadministered to the patient. As the pharmaceutical is drawn out of thecontainer via the needle cannula, precautions must be taken to avoid airbeing drawn into the syringe. In rigid vials, air must be introducedinto the container to fill the void created as the liquid pharmaceuticalis withdrawn. This volume of air then becomes susceptible to being mixedwith the pharmaceutical or being drawn in through the needle cannula andcreating air pockets in the syringe barrel. Catastrophic consequencescould result if these air pockets are subsequently injected into thepatient along with the liquid pharmaceutical.

Some medical conditions necessitate such a rapid diagnosis andadministration of the necessary injection that precautionary measuresneeded to eliminate air content in the syringe are often compromised. Asan example, diagnosis and treatment of acute myocardial infarctionrequires rapid injection of a thrombolytic agent adjacent to theatherosclerotic plaque in a major epicardial coronary vessel. Minutes,or even seconds, can have profound impact on the treatment of thepatient. Thrombolytic agents, such as tissue plasminogen activator (TPA)or streptokinase usually must be injected immediately, while taking thetime for necessary precautions needed to prohibit air from becomingentrapped and compromising the drug.

Problems associated with injections are further complicated when themedication to be administered must be stored as two separate componentparts, then mixed, prior to injection. Dual chamber vials have beendeveloped to facilitate storage and mixing of these two-componentmedications. Common examples of multipart medications includemedications which must be mixed from a component A, usually apreservative or catalyst, and a component B, which is usually apharmaceutical. Component A or component B may be in powder orcrystalline form instead of liquid form.

Recently, dual chamber vials have been developed which allow an Acomponent and a B component to remain separated in independent chamberswithin a single package until mixing is desired. The vial allows mixingof the component parts in that same unitary package. In an example ofsuch a device is the MIX-0-VIAL two compartment vial manufactured by theUpjohn Company of Kalamazoo, Mich. This device is a single vialcontainer having two chambers separated by a small stopper. The septumis formed by a plunger-stopper at one end which is used to pressurizethe contents of one chamber so to displace a plug lodged in a smallorifice separating the two chambers. As the plunger stopper is displaced(by giving it a quarter turn), the plug floats freely into one of thechambers and is used as an agitator to mix the two component partstogether. The two components are free to flow between chambers throughthe connecting orifice and thereby mix together. Although this device isa significant advance in dual chamber vials, the device has least twosignificant disadvantages. First, once the protective cap is removed,there is nothing to prohibit a user from penetrating the septum with aneedle cannula and inadvertently drawing out only one of the componentparts separately prior to mixing. Such an event could be extremelyhazardous to the health of the patient. Second, even when the twocomponents are properly mixed, when a needle cannula penetrates theseptum and draws out the mixed medication, air becomes entrapped in thevial as air enters to replace the removed liquid as the medication iswithdrawn. Time consuming precautions must be taken to carefully avoidentrapping air in the syringe and injecting the same into the patient.

SUMMARY OF THE INVENTION

The present invention is directed to a multi-chamber vial which providesboth protection against inadvertent withdrawal of one of the componentparts of the multipart medication prior to mixing, and a mechanism whicheliminates entrapment of air in the medication chamber as the medicationis withdrawn.

Generally, the invention relates to vials used for containment ofmedication substances or pharmaceuticals. More specifically, theinvention relates to vial which can store pharmaceuticals made from twocomponent parts where there is a desire to keep the two component partsseparated until the time necessary to mix the components together. Thedevice has two (or more) chambers separated by a rupturable barrierwhich keeps the component parts isolated from each other until mixing isdesired. The device is made from materials which eliminate thepossibility of a needle cannula accessing either component of thepharmaceutical prior to mixing.

When the components are to be mixed, the contents of one chamber areforced into the other chamber by pressurizing the contents of the onechamber. This is preferably accomplished using a telescoping device sothe opposite ends of the device are simply pressed together causingfluid pressure to rupture the barrier separating the two chambers. Theone chamber could also be in the form of a flexible bag, a bellows orsuch other structure. The rupturing can be by dislodging a plug or likeelement, tearing a flexible diaphragm, breaking a solid frangiblesealing element, moving a resilient sealing element, or by other means.Once the barrier is ruptured, the component in the one chamber, termedthe second or supplemental chamber, is forced into the other chamber,termed the first or mixing chamber, as the device is compressed. The twocomponents are mixed by the resulting turbulence as the mixing chamberfills with the mixed pharmaceutical.

The mixing chamber is a variable volume chamber. This is achieved bymaking the mixing chamber a piston and tube, preferably a cylinder,arrangement. The piston travels within the cylinder to increase the sizeof the mixing chamber as the fluid volume grows. The piston continues totravel until both components are within the mixing chamber; at thispoint, the piston is forced against a removable safety shield coveringthe upper end of the cylinder. Only when the safety shield is dislodgedfrom its position covering the end of the cylinder is the user permittedaccess to the contents of the vial through the piston.

The piston serves several functions: it permits the mixing chamber to bea variable volume chamber to permit mixing of two liquid componentswithout the entrainment of air; it serves as the septum to permit useraccess to the mixed contents of the mixing chamber by a hollow needle;it permits the mixing chamber to automatically lessen its volume as themixed contents are removed to eliminate the need to introduce air intothe chamber and thus reduce risk; it acts to automatically dislodge thesafety shield once the contents of the chambers are combined. Whenmixing a solid and a liquid, the solid being in the mixing chamber, theuse of the piston minimizes the amount of air or other gas in the mixingchamber.

The invention can be practiced in a manner which substantially preventsinadvertent mixing of the components. One way to do this is to mount ahousing to the cylinder which partially defines the mixing chamber. Ahousing base is mounted to the receptacle partially defining thesupplemental chamber. The housing and housing base are interconnected sothat when the vial is in the inactivated condition, an axial forcetending to telescope the housing and housing base together, which wouldresult in collapsing the telescoping components, is prevented. Only whenthe housing and housing base are properly manipulated, such as bytwisting the housing and housing base relative to one another so that aradially extending tab carried by the housing base enters an axiallyextending slot formed in the housing, can the components be telescopedtogether. This relative rotary motion can be normally restricted throughthe use of a safety seal or label adhered to both the housing andhousing base. Only by breaking the safety seal or label would relativerotary motion between the two elements be possible.

Another safety feature which may be used instead of or in addition tothe coupling of the housing and housing base, is a removableantiactivation cap used with the housing. The antiactivation cap andhousing are sized so that they are at opposite ends of the vial and abutone another at their leading edges prior to causing the telescopiccomponents to collapse into one another. Only after the antiactivationcap is removed can the components be telescoped into one another. Thesafety seal or label can also be used to prevent inadvertent orunauthorized removal of the antiactivation cap and plainly signal anysuch removal of the cap.

Other features and advantages of the invention will appear from thefollowing description in which the preferred embodiments have been setforth in detail in conjunction with the accompanying drawings.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a perspective view of a preferred embodiment of the inventionfabricated primarily from clear materials and showing the vial in theinactivated or premixed condition.

FIG. 2 is an exploded side view of the device shown in FIG. 1illustrating the various component parts.

FIG. 3 is a cross-sectional view of the dual chamber vial in theinactivated condition of FIG. 1 showing a first and second chamberseparated by a diaphragm.

FIG. 4 shows the device in FIG. 3 being activated with the fluidpressure in the lower chamber tearing the diaphragm and causingturbulent mixing of the two components in the upper chamber with thepiston travelling upwards as the upper chamber fills with bothcomponents.

FIG. 5 shows the device illustrated in FIG. 4 in the fully activatedposition with the upper chamber filled with both mixed components andthe shield dislodged from the safety position.

FIG. 6 shows the device of FIG. 5 with the shield removed and a needlecannula of a syringe penetrating the piston to withdraw the mixedpharmaceutical.

FIG. 7 shows a cross-sectional view of an alternative embodiment of theinvention having a diaphragm which includes a plug on a tether, the plugbeing dislodged from the diaphragm to open a channel allowing the twocomponents to mix in the upper chamber.

FIG. 8 is a cross-sectional view of another alternative embodiment ofthe invention having a gasket connected to a plug by a perforateddiaphragm which, when inserted in an aperture of the cylinder, separatesthe two chambers.

FIG. 9 is an engaged perspective, partial cross-sectional view of thegasket used in the embodiment illustrated in FIG. 8.

FIG. 10 is an exploded orthographic view of a further alternativeembodiment of the vial of FIG. 1.

FIGS. 11A and 11B are side cross-sectional views of the vial of FIG. 10in the inactivated, telescopically extended condition and the fullyactivated, telescopically collapsed condition.

FIGS. 12A and 12B are external views of the vials of FIGS. 11A and 11B.

FIG. 13 is an enlarged end view of the safety shield of FIG. 10.

FIG. 14 is an enlarged cross-sectional view of the hinge portion of thehousing taken along line 14--14 of FIG. 11A.

DESCRIPTION OF THE PREFERRED EMBODIMENT

Referring the reader to FIGS. 1 and 3, vial 2 includes a cylinder 18,piston 14, and a supplemental container or receptacle 22. Cylinder 18and receptacle 22 are partially enclosed in housing 4. Housing 4,cylinder 18 and receptacle 22 are fabricated from transparent ortranslucent materials to allow the user to view the contents of vial 2.Cylinder 18 and receptacle 22 are preferably glass or a pharmaceuticallycompatible plastic; housing 4 is preferably made of polycarbonate.

Housing 4 is cylindrical in shape and has a pair of expansion slots 6located 180° apart. Upper surface 8 of housing 4 has a plurality ofgripping slots lo to provide a non-slip surface for the user. Aremovable shield 30 is connected to housing 4 in a recessed housingaperture 28. Shield 30 is preferably a one-piece molded part withhousing 4 and is connected to housing 4 by a continuous frangibleconnection 32. Alternatively, shield 30, as suggested in FIG. 13, couldbe friction fit or otherwise secured within the housing aperture 28. Ineither event, it is desired that shield 30 also keep the air space 55above piston 14 sterile. Catch 40 is formed on the inner surface ofhousing 4. The function of catch 40 will be explained more fully below.

Referring now to FIG. 2, vial 2 is shown in an exploded view from theside showing the component parts. Housing 4 is open at its lower end 12.Cylinder 18 has a first end 17 and a second end 19. Piston 14 includessealing ridges 16 sized to sealingly engage cylinder 18. Diaphragm 20 ismade to be disposed about second end 19 of cylinder 18 and has sealingridges 21 to create an air and liquid tight seal between outer surfaceof cylinder 18 and the inner surface of supplemental receptacle 22.Receptacle 22 is formed having a floor 26 and a rim 24. Rim 24 is formedto engage between a catch 36 and a protrusion 38 formed on housing 4when in the premixed condition of FIGS. 1 and 3 or to engage with catch40 on housing 4 when in the activated condition of FIG. 5.

Referring now to FIG. 3, showing vial 2 in the assembled and premixedcondition, cylinder 18 is disposed between the upper surface 8 ofhousing 4 and receptacle 22. Housing 4 has a shoulder 34 and a seat 42which is affixed to first end 17 of cylinder 18, such as by frictionfit. Shield 30, frangibly connected to shoulder 34 at 32, covers thefirst end 17 of cylinder 18. Shield 30 is made of a rigid material whichprohibits penetration by a needle cannula. As such, when shield 30covers first end 17 of cylinder 18, a needle cannula cannot penetratepiston 14. Second end 19 of cylinder 18 is also precluded frompenetration by a needle cannula in that it is enclosed by receptacle 22.Receptacle 22 is also made of a needle resistant material. In thepreferred embodiment, housing 4 and receptacle 22 are transparent, butshield 30 is colored on it outer surface, preferably bright red, toindicate that access to cylinder 18 is restricted.

When piston 14 is disposed in cylinder 18 and diaphragm 20 is disposedon second end 19 of cylinder 18, an airtight and liquid-tight firstchamber 56 is formed within cylinder 18. Diaphragm 20 seals betweencylinder 18 and the inner surface of receptacle 22 such that whenreceptacle 22 is secured within housing 4 with rim 24 between catch 36and protrusion 38, a second chamber 54 is formed between diaphragm 20and floor 26 of receptacle 22. As shown in the cross section of FIG. 3,the result is a dual chamber vial 2 having a first chamber 56 housing afirst component, and a second chamber 54 housing a second component whenvial 2 is in the premixed condition. Airspace 55 is formed betweenshield 30 and a flat surface 46 of piston 14.

In the embodiment shown in FIG. 3, diaphragm 20 is formed having acavity 48 forming a thin, reduced-strength membrane 50. The dimensionsof membrane 50 are such that diaphragm 20 can be ruptured or torn atmembrane 50 by sufficient fluid pressure as will be more fully describedbelow.

Referring now to FIG. 4, vial 2 is shown being activated as it iscompressed from the premixed condition. As previously stated, vial 2 inthe premixed condition shown in FIG. 3, isolates components in the firstchamber 56 from the components contained in second chamber 54.Separation of the two components may be desirable for shipping andstorage. When it is necessary to combine the two components, the usergrasps vial 2 by placing a finger against upper surface 8 of housing 4and a second finger or thumb 58 against the outer surface of floor 26 ofreceptacle 22. The user then squeezes his or her two fingers 60, 58together as indicated by arrows 62, 64. The resultant compression forcespressurizes the component located in second chamber 54 as receptacle 22slides up within housing 4.

Initially, vial 2 is taken out of the premixed condition as rim 24slides up and over protrusion 38. As rim 24 slides over protrusion 38,housing 4 is allowed to expand because of expansion slots 6. In thepreferred embodiment, second chamber 54 is initially filled with aliquid component. As receptacle 22 slides up into housing 4 towardsfirst end 17 of cylinder 18, fluid pressure in second chamber 54increases. The increase in fluid pressure causes thin membrane 50 ofdiaphragm 20 to rupture, thereby providing a channel 68 between secondchamber 54 and first chamber 56.

The user continues to assert compression force 62, 64 forcing the fluidcontents of second chamber 54 through channel 68 and into first chamber56 where the contents of second chamber 54 and first chamber 56turbulently mix as indicated by arrows 66. As the components mix infirst chamber 56, the fluid volume of chamber 56 increasesproportionally. The increase in volume in chamber 56 drives piston 14 upin cylinder 18 towards shield 30 as indicated by arrow 76. Air in airspace 55 escapes between the rim at first end 17 of cylinder 18 and seat42; a grooved air path or a one-way valve (to ensure sterility) may beprovided if desired. Only when the contents of second chamber 54 arecompletely exhausted into first chamber 56 is piston 14 driven againstshield 30 into a post-mixed condition illustrated in FIG. 5.

The post-mixed condition of vial 2, as shown in FIG. 5, is achieved whenreceptacle 22 is fully driven within housing 4 and the component partsof second chamber 54 and first chamber 56 have been turbulently mixedand combined within first chamber 56. When the increase in volume infirst chamber 56 drives piston 14 into shield 30, shield 30 is dislodgedfrom housing 4 by an audible snap. The audible snap is produced bybreaking of the frangible connections between shield 30 and housing 4.Alternatively, when shield 30 is positioned within housing aperture 28via a friction fit, as suggested in the embodiment of FIG. 13, audiblepop as shield 30 is dislodged from its friction fit within housingaperture 28 may also be created. An aural indication is also createdwhen rim 24 passes over catch 40. The user thus has an aural indicationwhen shield 30 is dislodged from housing 4. This aural indicator, inconjunction with the freeing of shield 30, indicates to the user thatthe contents are fully mixed within the variable volume first chamber56. Vial 2 is retained in the post-mixed condition by catch 40 retainingrim 24 of receptacle 22.

Once in the post-mixed condition, the shield 30 can be removed and aneedle cannula 78 can be inserted through piston 14, which acts as aseptum, as indicated in FIG. 6. Syringe 80 can now be used to draw outthe contents of variable volume mixing region 56 located in vial 2. Animportant aspect of the invention is that as the contents of variablevolume mixing region 56 is withdrawn from vial 2 through needle cannula78, the fluid volume of variable volume region 56 decreases. As thevolume decreases, the airtight and fluid-tight seals formed betweenpiston 14 and cylinder 18, in combination with the seal formed bydiaphragm 20 between receptacle 22 and cylinder 18, drives piston 14down cylinder 18 towards second end 19 by hydraulic suction and preventsany ambient air from becoming entrained in variable volume region 56.This feature substantially prevents any inadvertent air bubbles fromgathering within the pharmaceutical withdrawn from vial 2.

An alternative embodiment of the invention is shown in FIG. 7. In thealternative embodiment, diaphragm 82 has an opening 84 which is sealedby plug 86 in the premixed condition. Plug 86 may be connected todiaphragm 82 using tether 88. Plug 86 may also be a separate componentas well. When vial 2a is activated from the premixed condition to thepost-mixed condition, the increase in fluid pressure in second chamber54 causes plug 86 to dislodge from opening 84 allowing the components tomix in first chamber 56 as previously described. This embodiment has theadded feature that plug 86 can be used to additionally mix thecomponents combined in first chamber 56 when the user forcibly shakesvial 2a causing plug 86 to work as an agitator.

A second alternative embodiment of the invention is illustrated in FIGS.8 and 9. In the second alternative embodiment of the invention, cylinder18b is formed having second end 19b with a small aperture 101. Gasket 92seals between cylinder 18b and receptacle 22. Gasket 92 is more fullydepicted in FIG. 9. Gasket 92 is formed having a plurality of holes 94formed through a membrane 95 to which a stem 104 of plug 96 extends.Plug 96 is positionable in aperture 101 to seal and isolate firstchamber 56 and second chamber 54 in the premixed position. When vial 2bis moved from the premixed position, fluid pressure in second chamber 54causes plug 96 to be dislodged from aperture 101 forming a channel 110between first chamber 56 and second chamber 54.

A further embodiment of the invention is shown in FIGS. 10-14. Vial 202is similar to vial 2 and includes a housing 204 which mounts to the end206 of a cylinder 208. This is achieved by positioning end 206 ofcylinder 208 against a complementary mating surface 210 formed withinhousing 204. End 206 is preferably mounted to surface 210 using anadhesive or through a snug fit.

Cylinder 208 includes a diaphragm assembly 212 mounted to a second end214 of cylinder 208. Diaphragm assembly 212 includes an elastomericsealing element 216 and a pharmaceutically inert insert 218, preferablyPTFE, commonly sold as Teflon®. Element 216 has external sealing ridges220, 222 which engage the inner surface 224 of a cup-shaped receptacle226. Receptacle 226 is preferably a cup-shaped glass container and ishoused within a plastic protective housing 227. Protective housing 227,with receptacle 226 therein, is sized to fit closely but slidinglywithin housing 204 as shown in FIG. 11A.

Cylinder 208 includes an elastomeric piston 228 sized to move within theinterior 230 of cylinder 208. Cylinder 208, piston 228 and diaphragmassembly 212 define a first, mixing chamber 232 which contains a firstcomponent. In the disclosed embodiment first, mixing chamber 232 housesa liquid; it could, however, house a dry or lyophilized component aswell. A second, supplemental chamber 234 is defined by receptacle 226and diaphragm assembly 212. Chamber 234 contains a flowable component,preferably liquid, which, upon activation of vial 202, flows into first,mixing chamber 232 so to mix with the first component for subsequentuse.

Vial 202 has a tamper-evident seal 236 adhered to the outer surface 238of housing 204 and the outer surface 240 of an antiactivation cap 242mounted over the protruding end 244 of protective housing 227. Note thathousing 204 and antiactivation cap 242 meet or abut at position 246.Thus, with cap 242 in place, an axial compression force on vial 202would be resisted by housing 204 and cap 242 and not transferred tocylinder 208 and receptacle 226. After seal 236 is either broken orremoved, cap 242 can be removed to permit access to protective housing227.

Protective housing 227 has three equally spaced radially outwardlyextending tabs 248 which engage three axially extending slots 250 formedin housing 204. Each slot 250 incudes an offset region 252 at an endadjacent position 246. With vial 202 in the inactivated condition ofFIGS. 11A and 12A, radial tabs 248 are positioned in offset regions 252.To permit vial 202 to move from the inactivated condition of FIGS. 11Aand 12A to the fully activated condition of FIGS. 11B and 12B,protective housing 227 is rotated in the direction of arrow 254 to movetab 248 from region 252 and into alignment with the main portion 256 ofslot 250. The user then presses on the ends of vial 202 causingmushroom-shaped plug portion 258 of sealing element 216 to dislodge frominert insert 218 to permit fluid flow from second chamber 234, through acentral opening 260 formed within insert 218, and through several holes262 formed in element 216 and surrounding plug portion 258. Theresulting flow is sufficiently turbulent to ensure appropriate mixingwithin first, mixing chamber 232.

While this occurs, piston 228 moves within interior 230 towards a safetyshield 266 which is positioned adjacent end 206 of cylinder 208. Safetyshield 266, shown also in FIG. 13, includes pivot pegs 268 positionedwithin receptacles 270, see FIG. 14, formed in housing 204. As seen inFIGS. 12A and 12B, unlike safety shield 30 of vial 2, safety shield 266remains attached to housing 204 when vial 202 is in its fully actuatedcondition. Although safety shield 266 is pivotally attached to housing204, safety shield 266 could be an integral part of the housing with anintegrally molded hinge and one or more frangible connections to keepthe safety shield in position prior to activation.

Surface 272 has several slightly raised projections 274. This helps toprevent piston 228 from lying flush against elastomeric sealing element216. Also, surface 272 is slightly concave so that as the user draws themixed contents from chamber 232 (see FIG. 6), thus causing piston 228 tomove towards sealing element 216, any liquid around the periphery ofpiston 228 during the final portions of such a movement will tend to besqueezed inwardly towards the center, thus being more accessible to theneedle.

Once in the fully activated condition of FIGS. 11B and 12B, a rearwardlyfacing (that is, away from safety shield 266) abutment surface 276formed by protective housing 227 engages a forwardly facing abutmentsurface 278 formed by housing 204 to substantially prevent separation ofhousing 204 and protective housing 227. This helps prevent the reuse ofvial 202.

Other modifications and variations can be made to the disclosedembodiments without departing from the subject of the invention asdefined in the following claims. For example, although the contents ofthe second chamber will generally always be a liquid, the contents ofthe first chamber, before mixing, can be a liquid, a slurry or a solid.The opening at the second end of the cylinder could be through thesidewall of the cylinder. The housings are quite useful but optional. Ifthe housings are not used, the removable shield can be mounted directlywithin the interior of the cylinder adjacent its first end. This would,however, typically require some provision to permit air with an airspace 55 to escape when moving from the premixed condition of FIG. 3 tothe post-mixed condition of FIG. 5 while maintaining the interior ofcylinder 18 sterile. This could be accomplished, for example, throughthe use of a one-way valve. The mixed pharmaceutical could be accessedin ways other than by piercing the elastomeric piston, such as byremoving the piston or by removing a threaded plug formed within thepiston.

What is claimed is:
 1. A multi-chambered vial, comprising:acompressible, air tight, telescoping vessel, said vessel having an openend and a closed end and comprising a first chamber and a secondchamber, the first chamber and the second chamber coupled by an aperturefilled with an air tight and fluid tight rupturable seal, the open endof the vessel made air tight by a displaceable piston disposed in theopen end of said telescoping vessel and forming an air tight sealsealing the vessel from ambient air; and wherein when said telescopingvessel is compressed, pressure builds in the second chamber until theseal separating the first chamber and the second chamber is ruptured andthe contents of the second chamber enter into the first chamber andturbulently mix with the contents of the first chamber, therebyincreasing the volume in the first chamber by driving the piston towardsthe open end.
 2. The vial of claim 1 further comprising:a removableshield disposed over the open end of said vessel such that when saidshield is positioned over said open end of said vessel said vessel isimpenetrable to needle cannula; and wherein when the shield is dislodgedfrom the vessel, a needle cannula can access the contents of the vesselthrough the piston.
 3. The vial of claim 1 further comprising:a needlecannula impenetrable shield positioned over said open end of said vesselto prevent needle cannula access to the piston, said shield beingremovable by the piston when the piston is driven towards the open endand against the shield until the shield is at least partially dislodgedfrom the open end to permit needle cannula access to the piston.
 4. Amulti-chamber vial, comprising:a housing having a removable shield, saidhousing and said shield both fabricated from material which prohibitspenetration of a needle cannula; a receptacle having an open end and aclosed end, said open end having a rim formed about its periphery, saidreceptacle being slidably disposed relative to said housing, whereinsaid rim contacts said housing; a cylinder disposed in said housing andhaving a first end and a second end, said first end coupled to saidhousing such that said shield forms a removable barrier over said firstend, said second end extending away from said first end and having anaperture facing said receptacle; a removable resilient member disposedin said aperture and forming a liquid tight seal in said aperture; apiston disposed in said cylinder and forming a first chamber betweensaid piston and said resilient member; a gasket member disposed betweensaid cylinder and said receptacle, said receptacle forming a secondchamber sealed by said gasket member and said resilient member whereinthe receptacle can be moved in said housing toward the cylinder causingfluid pressure to build in the second chamber until the resilient memberis ruptured, thereby allowing the contents in the first chamber andsecond chamber to turbulently mix as the contents of the second chamberare forced through said aperture into the first chamber therebyincreasing the fluid volume contained in the first chamber and drivingthe piston towards the shield, wherein when all the contents of thesecond chamber are forced into the first chamber said piston dislodgesthe shield from the open end of the cylinder to allow a needle cannulato access the contents of the first chamber through the piston.
 5. Acomponent mixing vial, for use with first and second components, thesecond component being a liquid component, comprising:a mixing containerhaving first and second ends, openings at the first and second ends andan elongate tube portion towards the first end; a piston positionedwithin the elongate tube portion of the mixing container and movablefrom a premix position, away from the first end, to a post-mix position,towards the first end; a seal towards the second open end of the mixingcontainer, the first component being within a variable volume mixingregion between the seal and the piston, the seal contacting the mixingcontainer so as to sealably close the mixing container; a supplementalcontainer, containing the second component, the second open end beingpositioned within the supplemental container; means for forcing thesecond component past the seal into the variable volume mixing regioncausing the first and second components to mix and forcing the pistontowards the first end to the post-mix position; and means for accessingthe mixed components within the variable volume region.
 6. The vial ofclaim 5 wherein the accessing means includes a hollow needle pierceableportion of the piston so that the pierceable portion of the piston ispierceable by a hollow needle at the post-mix position to permit themixed components within the variable volume region to be withdrawnthrough the hollow needle.
 7. The vial of claim 6 further comprising aneedle resistant shield aligned with the first end of the mixingcontainer at a shield position for substantially preventing needleaccess to the piston when the piston is in the premix position, theshield being displaceable from the shield position by the piston whenthe piston is in the post-mix position to permit needle access to thepiston.
 8. The vial of claim 7 wherein the shield includes a plasticshield mounted over the open first end, the piston dislodging theplastic shield from the shield position when in the post-mix position.9. The vial of claim 6, further comprising means for preventing needleaccess to the piston while the piston is in the premix position and forpermitting needle access to the piston when the piston is in thepost-mix position.
 10. The vial of claim 5, wherein the mixing containeris cylindrical.
 11. The vial of claim 5, wherein the seal covers thesecond end.
 12. The vial of claim 5, wherein the seal includes adiaphragm with a pressure sensitive weakened region.
 13. The vial ofclaim 5 wherein the second component forcing means includes means fortelescopically sliding the mixing container and the supplementalcontainer towards one another.
 14. The vial of claim 13, wherein thesupplemental container slides over the second end of the mixingcontainer.
 15. The vial of claim 14, wherein the mixing container iscylindrical and the supplemental container is cup-shaped.
 16. The vialof claim 13, wherein the second component forcing means includes agasket sealingly positioned between the mixing container and thesupplemental container.
 17. A component mixing vial, for use with firstand second components, the second component being a liquid component,comprising:a mixing container having first and second ends, openings atthe first and second ends and an elongate tube portion towards the firstend; a piston positioned within the elongate tube portion of the mixingcontainer and movable from a premix position, away from the first end,to a post-mix position, towards the first end; a supplemental containertelescopically mounted to the second end of the mixing container; a sealtowards the second open end of the mixing container, the first componentbeing within a variable volume mixing region within the containerbetween the seal and the piston, the second component being within avariable volume storage region bounded at least in part by thesupplemental container and the seal; wherein the seal contacts themixing container so as to sealably close the mixing container; the sealincluding a normally sealed mixing path along which the second componentcan flow from the storage region to the mixing region as the mixing andsupplemental containers are moved from a telescopically extendedcondition to a telescopically collapsed condition; and means foraccessing the mixed components within the variable volume region. 18.The vial of claim 17 wherein the accessing means includes a hollowneedle pierceable portion of the piston so the pierceable portion of thepiston is pierceable by a hollow needle at the post-mix position topermit the mixed contents within the variable volume region to bewithdrawn through the hollow needle.
 19. The vial of claim 18 furthercomprising a needle resistant shield aligned with the first end of themixing container at a shield position for substantially preventingneedle access to the piston when the piston is in the premix position,the shield being displaceable from the shield position by the pistonwhen the piston is in the post-mix position to permit needle access tothe piston.
 20. The vial of claim 19 wherein the shield is pivotallymounted to the mixing container.
 21. The vial of claim 18 furthercomprising means for preventing the inadvertent movement of thecontainers to the telescopically collapsed condition.
 22. The vial ofclaim 18 further comprising a housing mounted to the mixing container.23. The vial of claim 22 further comprising a housing base mounted tothe supplemental container.
 24. The vial of claim 23 wherein the housingand the housing base include slot and extension means for helping toprevent inadvertent movement of the containers to the telescopicallycollapsed condition.
 25. The vial of claim 23 further comprisingantiactivation cap means, removably mountable to the supplementalcontainer, for preventing movement of the containers to thetelescopically collapsed condition by engagement with the housing. 26.The vial of claim 25 further comprising a tamper-evident seal associatedwith the antiactivation cap and the housing.
 27. The vial of claim 26wherein the seal is in the form of a label.
 28. The vial of claim 25further comprising a housing base mounted to the supplemental containerand to which the antiactivation cap means is mounted.